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Melanoma Metabolism: Molecular Mechanisms and Therapeutic Implications in Cutaneous Oncology
Background Melanoma, a highly aggressive skin cancer, is characterized by rapid progression and a high metastatic potential, presenting significant challenges in clinical oncology. A critical aspect of melanoma biology is its metabolic reprogramming, which supports tumor growth, survival, and therapeutic resistance. Objective This review aims to explore the key molecular mechanisms driving metabolic alterations in melanoma and their implications for developing therapeutic strategies. Methods A Pubmed search was conducted to analyze literature discussing key mechanisms of the Warburg effect, mitochondrial dysfunction, enhanced lipid metabolism, epigenetic modifications, and the tumor microenvironment. Results Metabolic reprogramming supports melanoma growth, proliferation, and survival. Understanding these complex metabolic dynamics provides valuable insights for developing targeted therapeutic strategies. Conclusion Potential therapeutic interventions aimed at disrupting melanoma metabolism highlight the promise of precision medicine in improving treatment outcomes in cutaneous oncology. By targeting metabolic vulnerabilities, novel treatment approaches could significantly enhance the clinical management and prognosis of melanoma. A critical aspect of melanoma biology is its metabolic reprogramming, which supports tumor growth, survival, and therapeutic resistance. This review explores the key molecular mechanisms driving metabolic alterations in melanoma, including the Warburg effect, mitochondrial dysfunction, and enhanced lipid metabolism.
Journal Article
Structural drivers of cutaneous leishmaniasis: Examining how the converging effects of displacement, environmental disruption, and political instability reshape epidemiology beyond endemic regions
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the Leishmania genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of drivers, including population displacement, environmental disruption, and political instability. These overlapping drivers contribute to expanding sand fly habitats, degrading living conditions, and weakening health systems, increasing transmission. Rising global temperatures further facilitate vector expansion into new regions, where clinical unfamiliarity often leads to misdiagnosis, delayed treatment, increased morbidity, and greater financial burden. Despite its rising incidence and global spread, CL remains a neglected tropical disease since it is seldom fatal, with scant interest by public health authorities and financial donors, limiting activities that further research and prevent spread of the disease. This review synthesizes current evidence on how geopolitical instability, forced migration, and climate-driven ecological changes collectively reshape CL epidemiology and complicate diagnosis, treatment, and surveillance. As CL extends beyond traditional geographic boundaries, it requires integrated strategies that address its multifaceted drivers through strengthened cross-border surveillance, provider education, and international coordination-focusing on prevention, diagnosis, and equitable access to diagnostics and therapeutics, especially among displaced and underserved populations.
Journal Article
Targeted Biologic Therapies for Hidradenitis Suppurativa
Chronic inflammatory disorders of the apocrine gland (CIDAP), such as hidradenitis suppurativa (HS), are characterized by painful, recurrent lesions in apocrine gland-rich areas. First-line treatments—including retinoids and antibiotics—often fail to prevent recurrence and biofilm formation, necessitating the use of targeted biologic therapies. This review evaluated U.S.-based randomized controlled trials and cohort studies published between 2014 and 2024 on the efficacy of such therapies in adult HS patients. A total of 13 studies met inclusion criteria. Agents targeting interleukins (IL-17A, IL-17F, IL-23, IL-1α, IL-36) and TNF-α were assessed, with outcomes including HiSCR, Sartorius scores, DLQI, and patient-reported measures. IL-17 inhibitors (secukinumab, bimekizumab) and IL-1 inhibitors (bermekimab, anakinra) demonstrated promising reductions in inflammatory burden and improved quality of life. TNF-α inhibitors, particularly adalimumab and infliximab, consistently achieved HiSCR and HSS improvements. Guselkumab (IL-23) showed limited efficacy in HiSCR but modest pain relief. Safety profiles were generally acceptable across agents, with few serious adverse events. Limitations across studies included small sample sizes, lack of control arms, and short follow-up durations. These findings underscore the therapeutic potential of biologic agents in managing HS. A greater emphasis on biomarker-guided treatment selection and interdisciplinary collaboration is warranted to optimize long-term outcomes for patients.
Journal Article
Cutaneous Leishmaniasis in the Context of Global Travel, Migration, Refugee Populations, and Humanitarian Crises
Cutaneous leishmaniasis (CL) is a vector-borne infection caused by protozoan parasites belonging to the genus Leishmania. CL is an emerging global health concern due to increasing migration, travel, and climate change. Traditionally, it was confined to endemic regions such as the Americas, the Middle East, and Central Asia; however, it is now spreading to non-endemic areas. Climate change has further contributed to the expansion of sandfly habitats, increasing CL transmission risk in previously unaffected areas. Healthcare providers in non-endemic regions often misdiagnose CL, delaying treatment and morbidity. Diagnosis remains challenging due to the need for species-specific identification, while treatment is limited by cost, availability, and personnel expertise. This review explores the epidemiology, clinical presentation, diagnostic challenges, and management of CL in the context of global mobility. It highlights rising CL cases in refugee settlements, particularly in Lebanon and Jordan, due to poor living conditions, inadequate vector control, and healthcare barriers. While there have been advances in systemic and topical therapies, access in refugee and resource-poor settings remains a barrier. Addressing the global burden of CL requires improved surveillance, healthcare provider training, and increased awareness. By enhancing global collaboration and policy changes, public health efforts can mitigate the expanding impact of CL.
Journal Article